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WO1986007262A1 - Formule dietetique ayant une teneur elevee en calories et en matieres grasses - Google Patents

Formule dietetique ayant une teneur elevee en calories et en matieres grasses Download PDF

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Publication number
WO1986007262A1
WO1986007262A1 PCT/US1986/001027 US8601027W WO8607262A1 WO 1986007262 A1 WO1986007262 A1 WO 1986007262A1 US 8601027 W US8601027 W US 8601027W WO 8607262 A1 WO8607262 A1 WO 8607262A1
Authority
WO
WIPO (PCT)
Prior art keywords
fat
grams
liter
composition
kcals
Prior art date
Application number
PCT/US1986/001027
Other languages
English (en)
Inventor
Vlado Simko
Original Assignee
The Research Foundation Of State University Of New
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by The Research Foundation Of State University Of New filed Critical The Research Foundation Of State University Of New
Publication of WO1986007262A1 publication Critical patent/WO1986007262A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/21—Esters, e.g. nitroglycerine, selenocyanates
    • A61K31/215—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids
    • A61K31/22—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acyclic acids, e.g. pravastatin
    • A61K31/23—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acyclic acids, e.g. pravastatin of acids having a carboxyl group bound to a chain of seven or more carbon atoms
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23L—FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES, NOT OTHERWISE PROVIDED FOR; PREPARATION OR TREATMENT THEREOF
    • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
    • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
    • A23L33/115—Fatty acids or derivatives thereof; Fats or oils

Definitions

  • Enteral hyperalimentation is usually the treatment of choice since it produces fewer side effects than the introduction of nutrients directly into a vein.
  • compositions presently marketed as complete therapeutic diets for enteral hyperalimentation all contain 2 Kcal/ml or less. These products have a low fat and high carbohydrate content. Carbohydrates are osmotically more active than fats. Low fat diets have a 25 higher osmolality which frequently leads to diarrhea. This reduces the feeding load of such products to less than 3500 Kcal/24 hours. Also, the lower caloric density of low fat diets precludes higher intake because of the volume limitations. Although central vein 30 hyperalimentation can provide more energy and nutrients, this mode of feeding has frequent serious side effects which limit the intake to below 4000 Kcal/24 hours.
  • compositions which would provide a higher caloric 3 intake via enteral hyperalimentation without side effects would obviously be desirable.
  • Such compositions have been unknown.
  • Low fat content of the presently available diets is based on the observation of 5 increased stool fat in malabsorption. ( See Davis- Christopher Textbook of Surgery, Ed. D. C. Sabiston, Jr., . B. Saunders Co., Philadelphia, Pa. ,(1977) p. 1021; Clinics In Gastroenterology, 8., 373 (1979) ; Gastrointestinal Disease, II, 2nd. Ed., . B. Saunders 10 Co., Philadelphia, Pa., (1978), "The Short Bowel Syndrome", Trier, 1137) .
  • compositions of the present invention is a high 20 caloric, high fat dietary composition having 2.5-3.6 Kcal/ ml and deriving 45-75% of its calories from fat.
  • This composition comprises:
  • the 30 composition is thus a nutritionally complete dietary composition capable of use in seriously ill patients without side effects. Its high Kcal/ml enables the patients to be fed a lower volume while the higher percentage of fat provides better patient tolerance and a 35 lower incidence of side effects.
  • the high caloric, high fat dietary composition of the present invention is prepared by conventional techniques for such dietary compositions.
  • 40 5 Non-fat sources for this new high caloric, high fat diet can be obtained in a liquid form from several commercial manufacturers. When appropriately mixed with dietary fat, these sources contain protein, carbohydrates, vitamins, minerals and trace metals at a level consistent 1 with the Recommended Daily Allowances. These commercial products can be obtained in fixed compositions or as individual nutrients. When adding the fat component, appropriate mixing and adequate use of emulsifying agents has to be made to assure a physically stable composition. 15
  • emulsifiers can be used to assure a stable lipid emulsion. From our experiments with different lipophilic and hydrophilic surfactants (phospholipids, carrageenan and tweens) , we obtained best 2 results with a commercial mixture of mono- and diglycerides at the level of 1 to 5 per cent of total fat.
  • the dietary fat is vigorously blenderized with the remaining 2 components of the diet for about 20 min at 15,000 to 22,000 rpm of the rotor.
  • the fat portion of the composition may be contributed by either an animal or vegetable source.
  • animal fats such as lard or butter have essentially equal caloric and nutritional values and can be used
  • vegetable oils are highly preferred in the 5 practice of the present invention due to their ready availability, ease of formulation, absence of cholesterol and lower concentration of saturated fatty acids.
  • Typical vegetable oils suitable for use in the composition of the present invention are those such as corn oil, sunflower 10 oil and soybean oil. Partially hydrogenated fats may also be utilized.
  • the digestion of fat can be 15 improved by additionally including in the fat portion of the composition of the present invention, a small proportion of dietary fat in the form of medium-chain triglyceride, e.g.. fractionated peanut oil.
  • medium-chain triglyceride e.g.. fractionated peanut oil.
  • the protein portion of the dietary composition of the present invention is typically a balanced source of 25 essential and non-essential amino acids such as calcium and sodium caseinate or egg white solid. Although free amino acids may also be used, partially hydrolyzed proteins (soy, meat or whey) or a complete protein such as soy protein isolate are preferable. 30
  • the carbohydrate portion of the dietary composition of the present invention is a blend of simple and complex carbohydrates. Suitable for use are glucose, fructose, sucrose, corn syrup, malt, maltose, isomaltose, partially 35 hydrolyzed corn starch, maltodextrins, glucose oligo/and polysaccharides. 5
  • the dietary compositions of the present invention also contain the recommended daily allowance of vitamins and minerals for adults so that they provide complete nutrition for a patient. Typically, vitamins A, B6, B12,
  • composition C, D, E and K and thiamine, riboflavin, niacin, calcium, 1 phosphorus, magnesium and zinc are included in the composition.
  • the amounts included in the composition are such that the adult recommended daily allowances of each will be provided upon ingestion of 1 - 2 liters of the dietary composition. 15
  • the concentration of vitamins and minerals in the present composition will be somewhat lower than found in the prior art formulation of this type. This is because the present compositions are better tolerated by 2 patients so that larger volumes of feeding are tolerated.
  • the anticipated daily dose of approximately 1.5 liters of the present composition will thus provide more than the recommended allowances of each of the necessary vitamins and minerals. If it is anticipated that a lower volume of 2 the present composition will be ingested by a given patient, the amounts of vitamins and minerals added to the composition can be adjusted in an appropriate manner so that the recommended daily allowances will be met.
  • the method of the present invention additionally comprises the feeding by enteral hyperalimentation using the compositions.
  • the patient will be fed from one to two liters/24 hour period of the compositions of the present invention. This will generally provide 3500- 35 6000 Kcal/24 hour period to the patient which will sustain the patient and, in most cases, even provide the patient with sufficient calories so as to afford a much desired weight gain.
  • One liter of a very high caloric, high fat dietary composition is formulated using the following:
  • This diet is indicated for patients with limited tolerance of dietary volume, e.h., after major gastric or small intestinal resections.
  • a high caloric, high fat dietary composition with 3.0 Kcal/ml is formulated using the following: 5 223 g vegetable oil (Mazola corn oil ) mixed with 777 g non-lipid components and other nutrients as in Table 1.
  • This formula can be used for most patients requiring vigorous enteral hyperalimentation. We have extensively 1 tested the tolerance, safety and nutritional response of this formula in metabolic clinical studies. The diet has a bland taste which can be improved by the addition of artificial flavorings.
  • This formula can also be conveniently used as a high- caloric supplement to a regular diet to improve the intake of nutrients, with only a minimum additional volume load.
  • the best way to administration is via a feeding tube, with continuous flow 2 at 60-80 ml/hour.
  • a high caloric, high fat dietary composition of 2.5 2 Kcal/ml is formulated using the following:
  • This diet is indicated for patients requiring enteral hyperalimentation who are at a risk of dehydration, e.g., patients with impaired renal function and azotemia.
  • Table 1 below compares three embodiments of the present invention with liquid dietary formulas presently available on the market. All of the formulas can be defined as nutritionally complete, i.e.. 2000 ml. (2 liters) of the diet or less meet the recommended daily allowances of an adult for vitamins and minerals. As will be noted from the tables the three embodiments of the present invention differ substantially from the prior art formulas in that they have a high caloric density (greater 10 than 2.4 Kcals/ml.), a high fat content (greater than 100 grams/liter) and a high proportion of calories derived from fat relative to total calories (greater than 45%) .
  • the high cal 3 Kcal/ml (Example II) has a normal ketogenic index and a normal nitrogen/calorie ratio of 1:300. 35 Table 1 (contd)
  • Example II was fed to 10 patients for prolonged periods as the sole source of nutrition.
  • the average caloric intake/24 hours obtained was 3899 Kcals/patient over 232 patients/day. No complications were reported during this extensive feeding study where patients were up to four 15 weeks on this special diet, with intakes up to 8400

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  • Health & Medical Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Polymers & Plastics (AREA)
  • Medicinal Chemistry (AREA)
  • Nutrition Science (AREA)
  • Engineering & Computer Science (AREA)
  • Food Science & Technology (AREA)
  • Oil, Petroleum & Natural Gas (AREA)
  • Emergency Medicine (AREA)
  • Mycology (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Epidemiology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Coloring Foods And Improving Nutritive Qualities (AREA)

Abstract

Une composition diététique ayant une teneur élevée en calories et en matières grasses de plus de 2,5 Kcal/ml est destinée à être utilisée pour l'hyperalimentation par voie intestinale dans des cas de malnutrition grave. Ladite composition présente une proportion accrue de matières grasses, ce qui lui donne une densité calorique accrue et permet au patient de recevoir jusqu'à 6 000 Kcal/par période de 24 heures.
PCT/US1986/001027 1985-06-07 1986-05-12 Formule dietetique ayant une teneur elevee en calories et en matieres grasses WO1986007262A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US06/742,299 US4690820A (en) 1985-06-07 1985-06-07 High-caloric, high-fat dietary formula
US742,299 1985-06-07

Publications (1)

Publication Number Publication Date
WO1986007262A1 true WO1986007262A1 (fr) 1986-12-18

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1986/001027 WO1986007262A1 (fr) 1985-06-07 1986-05-12 Formule dietetique ayant une teneur elevee en calories et en matieres grasses

Country Status (3)

Country Link
US (1) US4690820A (fr)
EP (1) EP0225372A1 (fr)
WO (1) WO1986007262A1 (fr)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0395865A3 (fr) * 1989-05-05 1991-11-06 Clintec Nutrition Company Diète entérique pour patients ayant une maladie pulmonaire
EP0440734A4 (fr) * 1988-10-21 1994-02-09 University Of Cincinnati
WO1995022909A1 (fr) * 1994-02-25 1995-08-31 Mps International Food Works Inc. Composition dietetique
US5470839A (en) * 1993-04-22 1995-11-28 Clintec Nutrition Company Enteral diet and method for providing nutrition to a diabetic
GB2292522A (en) * 1994-08-22 1996-02-28 Gitta Carmen Conway Multi-vitamin preparation for treatment of the immune system
WO2011152707A1 (fr) * 2010-06-04 2011-12-08 N.V. Nutricia Formulation liquide stable à haute teneur en lipides
JPWO2021060430A1 (fr) * 2019-09-27 2021-04-01

Families Citing this family (21)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
SE8601828D0 (sv) * 1986-04-21 1986-04-21 Novo Industri As Enteral diet product and agent for production thereof
US4921877A (en) * 1986-10-27 1990-05-01 Abbott Laboratories Liquid nutritional formula for glucose intolerance
US4952606A (en) * 1988-04-05 1990-08-28 New England Deaconess Hospital Corporation Structured lipid containing dairy fat
US5698525A (en) * 1989-04-03 1997-12-16 Interneuron Pharmaceuticals, Inc. Reducing post-prandial fluctuations in plasma concentrations of large neutral amino acids (LNAA)
US5432162A (en) * 1989-04-03 1995-07-11 Interneuron Pharmaceuticals, Inc. Reducing post-prandial fluctuations in plasma concentrations of large neutral amino acids (LNAA)
US5290605A (en) * 1989-06-29 1994-03-01 Niva Shapira Sun-exposure nutritional supporting composition
US5179080A (en) * 1989-08-31 1993-01-12 Clinical Homecare, Corp. Formulations containing growth hormone and nutritional supplements, and methods of treating malnutrition in chronic lung disease
AU645070B2 (en) * 1990-04-10 1994-01-06 Nb International Technologies Use of short chain fatty acid containing lipids to maintain gastrointestinal integrity and function in patients DO NOT SEAL - SEE LETTER DATED 22.03.94
JPH07507058A (ja) * 1992-03-11 1995-08-03 インターニューロン　ファーマシューティカルズ，インコーポレーテッド 大型の中性アミノ酸（ｌｎａａ）の血中濃度の食後変動の低減
US5276018A (en) * 1992-07-17 1994-01-04 Brigham And Women's Hospital Composition comprising amino acids and methods for decreasing muscle breakdown
US5571553A (en) * 1992-09-18 1996-11-05 University Of Medicine And Dentistry Of New Jersey High energy food products containing partially hydrogenated structured lipids
US6187367B1 (en) 1997-09-25 2001-02-13 Protein Technologies International, Inc. Low viscosity meat emulsion and process for producing a protein composition useful to form a low viscosity meat emulsion
US6605310B2 (en) * 2001-06-06 2003-08-12 Nestec S.A. Calorically dense liquid oral supplement
CA2537452C (fr) * 2005-03-09 2013-12-24 Abbott Laboratories Liquide concentre d'enrichissement du lait humain
WO2010047581A1 (fr) * 2008-10-24 2010-04-29 N.V. Nutricia Composition liquide de protéines à haute teneur en matières grasses
EP2316283A1 (fr) * 2009-10-30 2011-05-04 Nestec S.A. Conteneur comportant des compositions non alcooliques avec des ingrédients actifs visibles
WO2012061242A1 (fr) 2010-11-02 2012-05-10 Abbott Laboratories Fortifiant stable, concentré, liquide, de lait maternel
US20130143867A1 (en) 2011-12-02 2013-06-06 Sychroneuron Inc. Acamprosate formulations, methods of using the same, and combinations comprising the same
WO2014027015A1 (fr) * 2012-08-14 2014-02-20 Nestec S.A. Procédé à bas ph pour la préparation de compositions pasteurisées comprenant des taux élevés de matière grasse, de protéines et de glucides
WO2014027022A1 (fr) * 2012-08-14 2014-02-20 Nestec S.A. Compositions diététiques pour le traitement de malnutrition, de maladies neurologiques et de maladies métaboliques
WO2014027023A1 (fr) * 2012-08-14 2014-02-20 Nestec S.A. Compositions diététiques pour le traitement de malnutrition, de maladies neurologiques et de maladies métaboliques

Citations (4)

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Publication number Priority date Publication date Assignee Title
DE2520606B1 (de) * 1975-05-09 1976-07-08 Maizena Gmbh Fruehgeborenennahrung
US4323563A (en) * 1978-10-31 1982-04-06 Ajinomoto Co., Inc. Fat emulsion for intravenous injection
US4423072A (en) * 1979-12-28 1983-12-27 The University Of Kentucky Research Foundation Method for improving the metabolic stability and survival of neonatal pigs
US4528197A (en) * 1983-01-26 1985-07-09 Kabivitrum Ab Controlled triglyceride nutrition for hypercatabolic mammals

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2520606B1 (de) * 1975-05-09 1976-07-08 Maizena Gmbh Fruehgeborenennahrung
US4323563A (en) * 1978-10-31 1982-04-06 Ajinomoto Co., Inc. Fat emulsion for intravenous injection
US4423072A (en) * 1979-12-28 1983-12-27 The University Of Kentucky Research Foundation Method for improving the metabolic stability and survival of neonatal pigs
US4528197A (en) * 1983-01-26 1985-07-09 Kabivitrum Ab Controlled triglyceride nutrition for hypercatabolic mammals

Non-Patent Citations (5)

* Cited by examiner, † Cited by third party
Title
AMA Drug Evaluation, 4th Ed. 1982, (New york), NY), see pages 856-857. *
CHEMICAL ABSTRACTS, Volume 91, No. 9, 27, August 1979, (Columbus, Ohio, US.A), D. BRUNNER et al, 'Serum Lipid Response to a High-Caloric High Fat Diet, in Agricultural Workers During 12 Months' see page 500, colmn 1, Abstract No. 73478a, Am. J. Clin. Nutr. 1979, 32(6):1342-9, (Eng.). *
Handbook of Non Prescription Drugs 6th Ed. 1977, January (Washington, D.C.) M. MC KENZIE et al, Infant Formula Products, see pages 206 and 207. *
Physicians' Desk Reference, 30th Ed. 1976 (Oradell N.J.) C. E. BAKER, see page 780, 1021-1024, 1032-1033 and 1327. *
Physicians' Desk Reference, 31th Ed. 1977, (Oradell, N.J.) C. E. BAKER, see page 1575. *

Cited By (17)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0440734A4 (fr) * 1988-10-21 1994-02-09 University Of Cincinnati
EP0395865A3 (fr) * 1989-05-05 1991-11-06 Clintec Nutrition Company Diète entérique pour patients ayant une maladie pulmonaire
US5116819A (en) * 1989-05-05 1992-05-26 Clintec Nutrition Co. Enteral diet for patients with pulmonary disease
US5166189A (en) * 1989-05-05 1992-11-24 Clintec Nutrition Co. Enteral diet for patients with pulmonary disease
US5470839A (en) * 1993-04-22 1995-11-28 Clintec Nutrition Company Enteral diet and method for providing nutrition to a diabetic
WO1995022909A1 (fr) * 1994-02-25 1995-08-31 Mps International Food Works Inc. Composition dietetique
US5480865A (en) * 1994-02-25 1996-01-02 Parkinson's Charitable Trust Nutritional composition
GB2292522B (en) * 1994-08-22 1999-01-27 Gitta Carmen Conway A nutritional preparation for the human or animal immune system
GB2292522A (en) * 1994-08-22 1996-02-28 Gitta Carmen Conway Multi-vitamin preparation for treatment of the immune system
WO2011152707A1 (fr) * 2010-06-04 2011-12-08 N.V. Nutricia Formulation liquide stable à haute teneur en lipides
WO2011152730A3 (fr) * 2010-06-04 2012-01-26 N.V. Nutricia Formulation liquide stable, riche en lipides
CN103037712A (zh) * 2010-06-04 2013-04-10 N·V·努特里奇亚 稳定的高脂质液体配方物
US8975222B2 (en) 2010-06-04 2015-03-10 N.V. Nutricia Stable high lipid liquid formula
CN103037712B (zh) * 2010-06-04 2015-11-25 N·V·努特里奇亚 稳定的高脂质液体配方物
CN105288587A (zh) * 2010-06-04 2016-02-03 N·V·努特里奇亚 稳定的高脂质液体配方物
CN105288587B (zh) * 2010-06-04 2020-11-24 N·V·努特里奇亚 稳定的高脂质液体配方物
JPWO2021060430A1 (fr) * 2019-09-27 2021-04-01

Also Published As

Publication number Publication date
US4690820A (en) 1987-09-01
EP0225372A1 (fr) 1987-06-16

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